乌司他丁联合奥曲肽治疗重症胰腺炎的临床疗效

目的 探讨乌司他丁联合奥曲肽治疗重症胰腺炎临床疗效和免疫功能的变化.方法 选取2018年8月-2020年8月本院收治的重症胰腺炎患者168例,根据随机数表法分为联合组和奥曲肽组各84例,奥曲肽组使用奥曲肽进行治疗,联合组患者在此基础上给予乌司他丁进行联合治疗,观察两组患者临床症状缓解情况,并对两组患者治疗前后炎性因子水...

Clinical efficacy of ulinastatin combined with octreotide in treatment of severe pancreatitis

Objective To investigate the clinical efficacy and immune function of ulinastatin combined with octreotide in the treatment of severe pancreatitis.Methods A total of 168 patients with severe pancreatitis admitted to our hospital from August 2018 to August 2020 were selected and randomly divided into a combination group and an octreotide group with 84 cases in each group.The octreotide group was treated with octreotide,while the combination group was treated with ulinastatin on the basis of octreotide.The levels of inflammatory factors and immune function were investigated and compared between the two groups before and after the treatment.The clinical symptoms of the two groups were observed.The levels of inflammatory factors and immune function of the two groups before and after the treatment were compared.Results The total effective rate of the combination group(94.05%) was higher than that of the control group(85.71%),and the difference was statistically significant(χ²=9.767,P=0.008).The remission time of abdominal pain,disappearance time of abdominal distension,disappearance time of fever,recovery time of blood amylase and recovery time of urine amylase in the combination group were(3.28±0.29) d,(2.38±0.46) d,(4.54±0.53) d,(5.14±0.69) d and(4.06±0.59) d respectively,which were less than those in the octreotide group (5.15±0.62) d,(5.13±0.72) d,(7.82±0.87) d,(7.19±0.91) d and(8.25±1.58) d respectively,(t=25.040,29.499,29.509,16.452,22.769 respectively,all P <0.01)].There was no significant difference in inflammatory factors between the two groups before the treatment(P> 0.05);after the treatment,the levels of CRP,TNF-αand IL-6 decreased in both groups.In the combination group,the levels of CRP,TNF-α and IL-6 were(5.63±0.55) mg/L,(178.29±19.38) pg/ml,and(31.41±3.24) pg/ml respectively,which were lower than those in the octreotide group (14.16±2.58) mg/L,(249.62±25.91) pg/ml,and(54.73±6.38) pg/ml respectively,(t= 29.636,28.374,29.869,P <0.01).Before the treatment,there were no significant differences in inflammatory factors between the two groups(P> 0.05);after the treatment,the levels of IgA,IgG and IgM in both groups were increased.The level of IgG in the combination group was(19.52±2.06) g/L,which was higher than that (15.73±1.51) g/L] in the octreotide group(t=13.600,P <0.01).Conclusion Ulinastatin combined with octreotide in the treatment of severe pancreatitis can significantly alleviate the clinical symptoms of patients,reduce the inflammation of patients,and improve the immune function level of patients,which is worthy of further clinical promotion.